This form requires JavaScript, which appears to be disabled on your browser. Please enable JavaScript and reload this page, or call us at 510-653-1594 to complete your registration over the phone.
Registration Form
Please fill out form completely.
You may also register by contacting (514) 303-7605 or
claude-laroche@videotron.ca
.
If paying with check, contact above coordinator.
*
= Required Fields
First Name:
*
Last Name:
*
Address 1:
*
Address 2:
City:
*
Province:
*
(use 2 letter abbreviation)
Postal Code:
*
Country (if not Canada):
Email Address:
*
Phone:
*
Program:
*
Please Select a Program
Tuition
*
Please Select Payment Date
Comments:
NOTE
- Once your enrollment request is received, we'll review it to ensure there is space available as requested, review prerequisites (if any) are met and contact you if there are any questions. You will then receive a PayPal invoice. Once we receive payment we will send you confirmation & logistics material. Thank you!
If paying a deposit, the balance will automatically be charged three weeks before the workshop start.
By submitting form you acknowledge you have met the workshop prerequisites; understand the workshop content; understand workshop includes nudity and erotic touch; you are physically able to participate, you agree to keep our workshop drug and alcohol free; and you have read and agree to the
refund policy.
Thank you for joining us.
Homepage
SSL Certs
